Medicare’s Fall Open Enrollment Period (OEP) is a busy time for beneficiaries and those who help them evaluate their health care and prescription drug coverage options. From October 15 to December 7 each year, people with Medicare can make changes to their coverage, such as switching Part D prescription drug plans, or switching between Original Medicare and Medicare Advantage. This annual decision-making process can be complex, and several changes this year are making it even more so.

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule that expands Medicare coverage for Opioid Use Disorder (OUD). Recent legislation, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, established a pathway for this more comprehensive Medicare coverage of OUD services. Beginning on January 1, 2020, Medicare Part B will cover OUD treatment—including methadone for Medication Assisted Therapy (MAT)—furnished by an Opioid Treatment Program (OTP) under a bundled payment mechanism. This means a significant improvement in access to OUD care for people with Medicare, including for those who are dually eligible for Medicaid.

Last week, the Centers for Medicare & Medicaid Services (CMS) announced
the Medicare Part B premium for 2020. Starting January 1, the standard Part B premium will increase from $135.50 to $144.60 per month.

A new analysis from the Kaiser Family Foundation (KFF) underscores these challenges. According to the report, people with Original Medicare spent an average of $5,460 out of their own pockets for health care in 2016. Nearly half of this spending was for services outside of Medicare, such as LTSS (32%) and dental care (14%). The other half was largely devoted to meeting beneficiary cost-sharing obligations, including for provider-based care (22%) and prescription drugs (21%).

This week, a federal court blocked a Trump administration rule that would have allowed health plans and providers to refuse to provide certain types of care they disagreed with on moral or religious grounds. Set to take effect on November 22, the rule would have permitted individuals to deny care even in circumstances where performing the refused service was a significant portion of their jobs, and even where the refusal could prevent patients from receiving the service altogether.

With more than 22 million people with Medicare (34%) enrolled in Medicare Advantage plans in 2019, the private plan alternative to the

This week, the Centers for Medicare & Medicaid Services (CMS) announced in guidance the phase out and extension of a critical relief

In recent weeks, several committees within the U.S. House of Representatives—Energy & Commerce, Education & Labor, and Ways & Means—have been working to finalize the House’s drug pricing bill, HR 3. While the bill advanced by each committee differs slightly, the underlying goals are unchanged from the version initially introduced.

This month, five federal courts temporarily blocked a Trump administration final rule that would greatly harm families and prevent people

Some changes are in store for Part D in 2020 and policymakers are contemplating even more. The Kaiser Family Foundation (KFF), a nonpartisan nonprofit focused on national health issues, recently outlined what the program will look like next year under current law, and under recent legislative and administrative proposals.